Clinical Psychologist, Acting Assistant Professor
Research Interests
- Schizophrenia spectrum and other psychotic disorders
- Implementation of evidence-based treatments for people with serious mental illness
- Development and evaluation of digital mental health technologies
- Effects of loneliness and social isolation on mental health outcomes
- Intensive longitudinal data collection methods
Education
- PhD in Clinical Psychology, 2023 Minor: Quantitative Psychology University of Washington
- Predoctoral Internship, 2023 UW School of Medicine Harborview Medical Center Seattle Cancer Care Alliance
- MS in Clinical Psychology, 2016 University of Washington
- BS in Psychology, 2013 Minor: Ethics University of Washington
Project Ping |
Project Ping is research study at the University of Washington Department of Psychology. We are interested in learning more about how our mood and thoughts change throughout the course of a day. We are also interested in understanding how our interactions with others impact our mood and thoughts. Participants will take 5 brief surveys on their smartphone everyday for 14 days, where they will answer questions about their mood and interactions with others.
More information can be found here
UW COVID-19 Response Study |
King County, WA was the first the epicenter of the COVID-19 outbreak in the United States, and the disease appears to be spreading rapidly across the region and beyond. The purpose of this research is to understand how an outbreak such as this affect our mental and social well-being and how these in turn influence our own behavioral response. We are recruiting adults (18+) who currently live in King County, WA to participate in this research. Participants took a brief (3 minute) survey on their smart phones every evening for 2.5 months, where they will be asked about their emotional, behavioral, and social responses to COVID-19.
Please contact us with any questions: uwcovid19@uw.edu
Project Connect |
Relationships matter.
A defining feature of being human is our need for social connection. Surrounding ourselves with people who understand us, join us, and support us is vital to our happiness and well-being. In fact, doing so protects us against mental and physical illness such as depression and cardiovascular problems.
We are conducting research at our Center to understand processes involved in the formation of healthy, supportive relationships, and we need your help. Specifically, we will examine how feelings of connection with others change naturally over time and in response to either weekly counseling or weekly webinars.
Participants in this research will come to our Center at the University of Washington 3 times over the course of 4 months as well as complete brief surveys on your phone every day.
Please contact us with any questions: 206-616-7450 | uwcssc@uw.edu
- Exploring associations between affect and marijuana use in everyday life via specification curve analysis. Journal of Psychopathology and Clinical Science, 2023 Although frequently hypothesized, the evidence for associations between affect and marijuana use in everyday life remains ambiguous. Inconsistent findings across existing work may be due, in part, to differences in study design and analytic decisions, such as study inclusion criteria, the operationalization of affect, or the timing of affect assessment. We used specification curves to assess the robustness of the evidence for affect predicting same-day marijuana use and marijuana use predicting next-day affect across several hundred models that varied in terms of decisions that reflect those typical in this literature (e.g., whether to average affect prior to marijuana use or select the affect report closest in time to marijuana use). We fitted these curves to data from two ecological momentary assessment studies of regular marijuana and/or alcohol using college students (N = 287). Results provided robust evidence that marijuana use was slightly less likely following experiences of negative affect and slightly more likely following positive affect. Specification curves suggested that differences in previous findings are most likely a function of the specific emotion items used to represent affect rather than differences in inclusion criteria, the temporal assessment and modeling of affect, or the covariates added to the model. There was little evidence for an association between marijuana use and next-day affect. Overall, our findings provide evidence against the predictions made by affect reinforcement models in college students and suggest that future research should model the associations of marijuana use with discrete emotional states rather than general negative and positive affect.
- The daily association between affect and alcohol use: A meta-analysis of individual participant data Psychological Bulletin 2023 Influential psychological theories hypothesize that people consume alcohol in response to the experience of both negative and positive emotions. Despite two decades of daily diary and ecological momentary assessment research, it remains unclear whether people consume more alcohol on days they experience higher negative and positive affects in everyday life. In this preregistered meta-analysis, we synthesized the evidence for these daily associations between affect and alcohol use. We included individual participant data from 69 studies (N = 12,394), which used daily and momentary surveys to assess the affect and the number of alcoholic drinks consumed. Results indicate that people are not more likely to drink on days they experience high negative affect but are more likely to drink and drink heavily on days high in positive affect. People self-reporting a motivational tendency to drink-to-cope and drink-to-enhance consumed more alcohol but not on days they experienced higher negative and positive affects. Results were robust across different operationalizations of affect, study designs, study populations, and individual characteristics. These findings challenge the long-held belief that people drink more alcohol following increase in negative affect. Integrating these findings under different theoretical models and limitations of this field of research, we collectively propose an agenda for future research to explore open questions surrounding affect and alcohol use.
- An experimental investigation into the effect of negative affect on the behavioral economic demand for alcohol Psychology of Addictive Behaviors 2022 Influential theoretical models hypothesize that alcohol use is an especially potent reinforcer when used as a strategy to cope with negative affect. Although the evidence for this idea in observational data is weak, some experimental evidence suggests that the behavioral economic demand for alcohol increases immediately following a negative emotional event. Because existing studies testing the effect of negative mood inductions on the demand for alcohol have several methodological limitations and do not take inter- and intraindividual variability into account, we developed an improved experimental design to increase our confidence in any potential within-person effect of negative mood inductions on alcohol demand as well as to test whether this effect exhibits systematic inter- and intraindividual variability. We hypothesize that people will show a higher demand for alcohol following negative compared to neutral mood inductions and that this effect is stronger in heavy compared to light drinkers as well as stronger on days characterized by higher coping motives and negative urgency. Three hundred twenty college students will complete the alcohol purchase task (APT) after being subjected to 100 mood inductions (six negative, six neutral) on 20 separate days
- The effect of social interaction quantity and quality on depressed mood and loneliness: A daily diary study Journal of Social and Personal Relationships 2021 Concerns about the possible effects of social distancing during the COVID-19 pandemic highlighted several gaps in our knowledge about the association between social interactions and mental health. The current study aimed to characterize the unique effect of social interaction quantity and quality on daily depressed mood and loneliness and to identify the degree to which these processes operate at the within-person and between-person levels of analysis. A community sample of 515 adults was recruited to participate in 75 days of daily surveys. Participants reported on daily feelings of loneliness, depressed mood, social interaction frequency, engagement in vulnerable self-disclosure, and perceived responsiveness. Linear mixed models were used to identify the effect of daily social interaction quantity and quality on loneliness and depressed mood and to characterize the degree to which these effects varied across individuals. Social interaction quantity and perceived responsiveness were negatively associated with depressed mood and loneliness at the within-person level of analysis. Perceived responsiveness was also negatively associated with depressed mood and loneliness at both the within-person and between-person levels of analysis. Random slopes analysis revealed substantial heterogeneity in the within-person effects. The non-experimental design of this study precludes drawing causal conclusions. Furthermore, demographic and/or geographic differences in the observed effects may limit generalization. Engaging in more frequent, high-quality interactions may protect against daily depressed mood and loneliness despite one’s average level of these variables. Future research is needed to establish causality and identify the degree to which these findings generalize across samples and time.
- A Brief, Mobile Intervention to Decrease Depression and Loneliness and Improve Relationship Quality During the Covid-19 Pandemic Journal of Social and Clinical Psychology 2021 Effective, scalable interventions to address depression and loneliness and improve the quality of social relationships are needed for public health in pandemic and non-pandemic contexts. Towards this end, a randomized, controlled trial tested a mobile-based intervention, derived from social psychological and relationship science, for improving relational well-being and decreasing depression and loneliness. Participants were randomly assigned to either intervention (n = 719) or assessment only (n = 701) conditions and completed daily diary surveys for 28 days in the midst of the first wave of the Covid-19 pandemic. In the middle 14 days of the study, intervention participants received daily text-message suggestions for improving relational and mental well-being. Results indicated that the intervention decreased depression and loneliness and improved relationships during the intervention period but these changes were not sustained when the intervention ceased. Discussion: Results are encouraging in that evidence-based suggestions can be scaled effectively but additional efforts are required to sustain improvements over time.
- An integrative contextual behavioral model of intimate relations Journal of Contextual Behavioral Science 2020 Intimate relationships matter to health and happiness. However, the vast scope of relationship research and the abundance of precise micro-theories has presented obstacles to the development of integrative theories with contextual-behavioral foundations that are oriented towards application of findings in domains of public health significance. Derived from the well-validated Interpersonal Process Model, which described intimacy as a dyadic exchange in which Person A engages in a vulnerable self-disclosure, Person B enacts a response, and Person A perceives the response as responsive, we present an integrative, analytic-abstractive, contextual-behavioral model of intimate relations. The model describes the intimacy process as a set of functional relations describing behaviors and responses of Persons A and B in context, languaged as middle-level terms to facilitate cross-disciplinary applications. Three primary relations of the model are non-verbal emotional expression (Person A) and safety (Person B), verbal self-disclosure (Person A) and validation (Person B), and asking (Person A) and giving (Person B). The model also emphasizes the importance of self- and other-awareness, expressions of closeness, and reciprocity as additional terms. Future research directions and potential applications are discussed.
- The measurement and structure of microaggressive communications by White people against Black people Race and Social Problems 2020 Previous research on microaggressions has emphasized the frequency of and distress produced by microaggressions as reported by people of color. The current research supplements the existing literature by developing a self-report measure of White individuals’ microaggressive likelihood against Black people, the Cultural Cognitions and Actions Scale (CCAS). Study 1 developed the CCAS through exploratory and confirmatory factor analyses of responses to CCAS items from a sample of 978 non-Hispanic White undergraduate students. The final scale comprised four factors (Negative Attitudes, Colorblindness, Objectifying, and Avoidance) assessing microaggressive likelihood, and CCAS total and factor scores were significantly related to several other indicators of racism and bias. Study 2 involved 31 of the previous participants in a lab-based discussion of race-related issues with a confederate and provided initial support for the predictive validity of the measure. Overall, this report supports a growing literature that microaggressions are more than innocuous, harmless behaviors, unrelated to racism, and instead represent relevant processes within the science of racism and bias. It also provides a potential means of testing the effectiveness of interventions intended to reduce the commission of microaggressions.
- Addressing microaggressions in racially charged patient-provider interactions: A pilot randomized trial BMC Medical Education 2020 Background: Racial bias in medical care is a significant public health issue, with increased focus on microaggressions and the quality of patient-provider interactions. Innovations in training interventions are needed to decrease microaggressions and improve provider communication and rapport with patients of color during medical encounters. Methods: This paper presents a pilot randomized trial of an innovative clinical workshop that employed a theoretical model from social and contextual behavioral sciences. The intervention specifically aimed to decrease providers’ likelihood of expressing biases and negative stereotypes when interacting with patients of color in racially charged moments, such as when patients discuss past incidents of discrimination. Workshop exercises were informed by research on the importance of mindfulness and interracial contact involving reciprocal exchanges of vulnerability and responsiveness. Twenty-five medical student and recent graduate participants were randomized to a workshop intervention or no intervention. Outcomes were measured via provider self-report and observed changes in targeted provider behaviors. Specifically, two independent, blind teams of coders assessed provider emotional rapport and responsiveness during simulated interracial patient encounters with standardized Black patients who presented specific racial challenges to participants. Results: Greater improvements in observed emotional rapport and responsiveness (indexing fewer microaggressions), improved self-reported explicit attitudes toward minoritized groups, and improved self-reported working alliance and closeness with the Black standardized patients were observed and reported by intervention participants. Conclusions: Medical providers may be more likely to exhibit bias with patients of color in specific racially charged moments during medical encounters. This small-sample pilot study suggests that interventions that directly intervene to help providers improve responding in these moments by incorporating mindfulness and interracial contact may be beneficial in reducing racial health disparities.
- Fear-of-Intimacy in the Interpersonal Process Model: An Investigation in Two Parts Journal of Social and Personal Relationships 2020 The interpersonal process model (IPM) suggests that closeness develops in relationships when two people reciprocally engage in vulnerable self-disclosure, respond to each other, and perceive each other’s responses as validating, understanding, and caring (responsive). Little is known about how fear-of-intimacy relates to this foundational intimacy process. We conducted two studies of fear-of-intimacy and the IPM. In Study 1, 146 high fear-of-intimacy participants were randomly assigned to either interact for 1 hr with a research assistant (RA) demonstrating high responsiveness, to interact for 1 hr with an RA displaying low responsiveness, or to view a nature video for 1 hr. Unlike previous experiments with undergraduates documenting that high responsiveness predicts closeness up to 2 weeks after the interaction, the current study with high fear-of-intimacy individuals found that high responsiveness predicted closeness immediately after the interaction but this was not sustained over time. In Study 2, we conducted structural modeling in a diverse sample of 216 survey respondents with a range of fear-of-intimacy scores. Consistent with previous studies, perceived responsiveness strongly predicted closeness. Fear-of-intimacy had negative direct effects on vulnerable self-disclosure and perceived responsiveness but a positive direct effect on closeness.
- Differential Associations Between Interpersonal Variables and Quality-of-Life in a Sample of College Students Quality of Life Research 2019 Humans are fundamentally social beings, and the relationships we form with others are crucial for our well-being. Research across a variety of domains has established the association between a variety of interpersonal factors and health outcomes, including quality-of-life. However, there is a need for a more integrative, holistic analysis of these variables and how they relate to one another. Undergraduate students (n = 1456) from four universities across the United States completed self-report measures of their quality-of-life and a variety of interpersonal factors identified as important predictors across the literature. We examined zero-order correlations between these measures and quality-of-life, estimated a path model to look at unique variance accounted for by each, and finally used network analysis to examine the network of direct and indirect associations among these variables and quality-of-life. Loneliness had the strongest association with quality-of-life across all analyses. When examining the unique association between quality-of-life and each interpersonal variable, six remained statistically significant: loneliness, social support, social connectedness, emotional intelligence, intimacy with one's romantic partner, and empathic concern. These results were supported by the network model, which found direct associations between quality-of-life and these six variables as well as indirect associations with all other interpersonal variables in the model. Results from this research suggest that interpersonal factors in general, and loneliness in particular, are strongly associated with quality-of-life. Future research is needed to establish the direction of these effects and examine for whom these findings are generalizable.
- Measuring Intimacy as a Contextual Behavioral Process: Psychometric Development and Evaluation of the Awareness, Courage, and Responsiveness Scale Journal of Contextual Behavioral Science 2019 High quality relationships are essential to psychological health and well-being, and relational intimacy is a core model of intimacy wherein individuals develop close, trusting relationships with one another. Functional Analytic Psychotherapy (FAP) is a contextual behavioral intervention approach that is well-equipped to target inter- personal processes through the provision of in-session, therapist mediated reinforcement of skillful intimate relating. Single-subject level analyses of FAP's efficacy and mechanism of action are supportive; however, there is a need for group-level research to evaluate its efficacy and generalizability. This paper presents the devel- opment of the Awareness, Courage, and Responsiveness Scale (ACRS), a self-report measure of behaviors es- sential to intimate relating informed by contextual behavioral science principles and Reis and Shaver's (1988) Intimacy Process Model. In this five-part study, functioning of the ACRS is examined in undergraduate student samples (Studies 1–3), an adult community sample (Study 3), non-clinical dyadic relationships (Study 4), and a clinical sample (Study 5). Strengths and limitations of the final measure are discussed.
- A Preliminary Test of a Social Connectedness Burnout Intervention for Mexican Mental Health Professionals The Psychological Record 2019 Job burnout is a condition that interferes significantly with quality of life and is related to stressful working environments, organizational climate, and client outcomes. The introduction of burnout prevention and "Helping the Helper" programs may produce significant benefits with respect to this issue. In this study, we assessed a weekly online "Helping the Helper" intervention based on the behavioral principles of Functional Analytic Psychotherapy (FAP) to improve social relationships, reduce burnout, and improve organizational climate and quality of life in mental health professionals. Six therapists of the Borderline Personality Disorder Clinic of Mexico's National Institute of Psychiatry participated in this study. Subjects answered three questionnaires (Maslach Burnout Inventory, Multidimensional Scale of Organizational Climate, and World Health Organization Quality of Life - BREF) at seven time points throughout the duration of the study. The intervention was implemented between time points three and five. Robust Improvement Rate Difference (R-IRD) scores were computed for each subject to assess for the intervention's efficacy. Results suggest preliminary support for the possibility of a "Helping the Helper" intervention based on FAP for reducing burnout and improving organizational climate among colleagues in a high-stress, public mental health setting.
- A Brief Contextual-Behavioral Intervention to Improve Relationships: A Randomized Trial Journal of Contexual Behavioral Science 2018 Higher quality relationships enhance our emotional well-being, physical health, and life-span. This study describes a four-session intervention for increasing closeness in romantic and non-romantic dyads. Three key relational constructs – awareness, courage and love (ACL) – were targeted in a randomized control trial comparing ACL (n = 36) with an active comparison condition (n = 34). ACL was a structured protocol involving four one- hour weekly sessions between a trained coach and both members of a relational dyad. Overall, results were mixed. While there were few signifi cant results for the full sample, for those with high fear of intimacy, the ACL intervention decreased fear of intimacy and improved social connectedness and intimacy between members of dyads compared to the control group post-intervention and at one-month follow-up. These results are encouraging for a potentially signifi cant subset of the general public with high fear of intimacy who can be helped to access the mental and physical health benefi ts of relationships
- The Antisemitism-Related Stress Inventory: Development and Preliminary Psychometric Evaluation Psychology of Violence 2018 Objective: This article describes the development and preliminary psychometric evaluation of the Antisemitism-Related Stress Inventory (ARSI), a multidimensional measure of the frequency and impact of antisemitic experiences of American Jews. As the first known attempt to measure antisemitism-related stress, the ARSI represents a novel contribution in this area. Method: Adult, American Jewish respondents (N = 500) completed a battery of measures, including 87 initial items for possible inclusion in the ARSI. An exploratory factor analysis determined the factor structure of and best items for inclusion in the final scale. Correlations with established measures of stress, satisfaction with life, self-esteem, and Jewish religious and cultural identity were computed to explore concurrent validity. Results: The final 30-item ARSI included three subscales capturing Individual Experiences of antisemitism (14 items), Collective Experiences of antisemitism (11 items), and experiences related to one's Personal Safety (five items). The ARSI demonstrated strong internal consistency and concurrent validity with measures of stress and satisfaction with life. Jewish cultural identity predicted a higher frequency of collective experiences of anti-Semitism, whereas religious identity predicted fewer individual experiences of antisemitism. Conclusion: Findings support the ARSI as a promising measure to understand the impact of antisemitism on American Jews. These findings are discussed in regard to their specific implications for future research, including the need for further investigation into the impact of antisemitism on the psychological health and well-being of American Jews and complex relations with multiple aspects of Jewish identity.
- A Comprehensive Review of Research on Functional Analytic Psychotherapy Clinical Psychology Review 2017 Functional Analytic Psychotherapy (FAP; Kohlenberg & Tsai, 1991) is a transdiagnostic approach to outpatient psychotherapy that presented guidelines to instantiate the behavioral principle of natural, social reinforcement applied to idiographic behavioral targets within a genuine and authentic psychotherapy relationship. We present the fi rst comprehensive review of research on FAP, including qualitative studies, uncontrolled and controlled single-case designs, group designs, and studies on training therapists in FAP. We conclude that current research support for FAP is promising but not suffi cient to justify claims that FAP is research-supported for specific psychiatric disorders. There is stronger support for FAP's mechanism of therapist-as-social reinforcer: FAP techniques, when appropriately applied to idiographically defi ned behavioral problems— primarily in the realm of social functioning — produce positive change in those behaviors.
- A Preliminary Report on the Relationship Between Microaggressions Against Black People and Racism Among White College Stuents Race and Social Problems 2017 Previous efforts to understand microaggressions have surveyed stigmatized group members' experiences of receiving microaggressions. This report presents the first attempt to measure self-reported likelihood of delivering microaggressions rather than receiving microaggressions and to explore the association between the likelihood of delivering microaggressions and racial prejudice. We conducted a cross-sectional survey of 33 black and 118 non-Hispanic white undergraduate students at a large public Southern/Midwest university. Black students reported the degree to which a series of statements would be experienced as microaggressive. White students reported their likelihood of delivering those statements and completed measures of racial prejudice. White students' self-reported likelihood of engaging in microaggressive acts was significantly related to all measures of racial prejudice. The single item "A lot of minorities are too sensitive" was the strongest predictor of negative feelings toward black people. Results offer preliminary support that the delivery of microaggressions by white students is not simply innocuous behavior and may be indicative of broad, complex, and negative racial attitudes and explicit underlying hostility and negative feelings toward black students.
- Relationship Science Informed Clinically Relevant Behaviors in Functional Analytic Psychotherapy: The Awareness, Courage, and Love Model Journal of Contextual Behavioral Science 2017 The use of idiographically defined target behaviors in Functional Analytic Psychotherapy (FAP) has limited participation in a reticulated model of treatment development. One way to address this limitation is to offer a standardized set of clinical targets for FAP. The current study details a method of identifying standardized treatment targets in FAP using the Awareness, Courage, and Love (ACL) model. The applicability of the model was assessed by evaluating the degree to which previously identified clinical targets in FAP research correspond with the proposed specific categories of the ACL model. There is an 83.67% fit between past idiographic targets and current standardized targets. We discuss how ACL may be clinically useful and encourage more integrative treatment development for FAP.
- Preliminary Findings on the Effects of Online Functional Analytic Psychotherapy Training on Therapist Competency The Psychological Record 2016 Functional Analytic Psychotherapy (FAP) is a contextual behavioral psychotherapy approach in which client behavior is shaped in the psychotherapy relationship and then generalized to out-of-session contexts. Efforts to train therapists in FAP have employed a parallel process, attempting to shape trainee behavior in an 8-week, live, online course in which trainees interact with each other in a series of experiential exercises. Previous research on the effects of this FAP training protocol have been hampered by reliance on trainee self-report and a lack of objective assessment of trainee behavior in actual sessions. In the current study, we developed and piloted an objective measure of FAP competency and employed it to assess outcomes in a FAP training study. Sixteen participants with a range of previous FAP training experiences were randomly assigned to an immediate FAP training or a waitlist-then-training group. Trainee self-report findings largely replicated findings from the previous study (Kanter, Tsai, Holman, & Koerner, 2012), with larger and more consistent effects found for trainees with fewer previous FAP training experiences. Objective assessment of in-session trainee behavior with the FAP Competency Scale suggested a significant effect of training, but these results were limited by missing data. These findings provide preliminary support for the hypothesis that engaging in a FAP training that functionally parallels the therapy process can enhance FAP therapist in-session competency.
- Reinforcement Matters: A Preliminary, Laboratory-Based Component-Process Analysis of Functional Analytic Psychotherapy's Model of Social Connection Journal of Contextual Behavioral Science 2015 A therapeutic model of social connection derived from Functional Analytic Psychotherapy (FAP) that applies to both the client's outside-of-therapy relationships and the psychotherapeutic relationship is explored in two studies. The model integrates established behavioral principles with existing research on the reciprocal process of self-disclosure and responsiveness that occurs during development of intimate relationships to highlight a promising therapeutic process. In this process, self-disclosure ("courage" in FAP's model) is evoked by the therapist and then reinforced with therapeutic responsiveness ("love" in the FAP model) resulting in improved self-disclosure and more connectedness in the therapy and other relationships. Study 1 included a sample of 77 undergraduate participants who self-disclosed responses to a series of closeness generating questions to undergraduate research assistants trained in respon- siveness. Findings indicated that social connection increased following this full procedure. Study 2 included a sample of 99 undergraduate participants and provided evidence that the responsiveness of the research assistant is key to promoting increased feelings of connectedness and also improves the depth of disclosure.
- A Brief, Interpersonally Oriented Mindfulness Intervention Incorporating Functional Analytic Psychotherapy's model of Awareness, Courage, and Love Journal of Contextual Behavioral Science 2015 A brief, group mindfulness intervention targeting both state mindfulness and social connectedness was developed based on Functional Analytic Psychotherapy's model of awareness, courage, and love. A total of 114 college students were randomly assigned to one of three conditions: (1) a nature video control, (2) a traditional intrapersonal mindfulness intervention focused on awareness of breath and private stimuli such as bodily sensations, thoughts, and feelings, or (3) an interpersonal mindfulness intervention that emphasized (a) expanding awareness from private internal to external public stimuli associated with the presence of others, (b) a contemplation of common humanity and risks participants could take to improve a specific relationship, and (c) a brief small group interaction involving courageous sharing of these risks. Results indicated significant benefits of all three conditions with respect to state mindfulness with both mindfulness conditions outperforming the nature video, and significant benefits of both mindfulness conditions with respect to social connectedness, with the interpersonal mindfulness condition outperforming the intrapersonal condition. Limitations include no follow-up data to explore the maintenance of gains over time.